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Learning From History

Learning From History. History and Mental Illness. Early views (e.g. the Dark Ages) on mental health equated mental illness with demonic possession. Witchcraft Curses from the Gods “Treatments”: Some were left to their own demise Burning at the stake Torture. Asylums and Hospitals.

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Learning From History

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  1. Learning From History

  2. History and Mental Illness • Early views (e.g. the Dark Ages) on mental health equated mental illness with demonic possession. • Witchcraft • Curses from the Gods • “Treatments”: • Some were left to their own demise • Burning at the stake • Torture

  3. Asylums and Hospitals • Asylums usually housed the mentally ill, poor people, and other discarded members of society. • One notorious asylum is Bethlehem Royal Hospital (Bedlam) • Put patients on display like animals at the zoo • Inhumane treatment of patients • Poor living conditions

  4. Treatments of Mental Illness • Blood letting • Ice baths • Insulin shock • Frontal Lobe Lobotomies • Electro-shock therapy

  5. Early Leaders of Reform • Philippe Pinel and Jean-Baptiste Pussin: • Unshackled patients and pushed for more humane treatment of mentally ill. • William Turke: • Founded York Retreat where patients were treated morally. • Led to similar establishments in America • Dorothea Dix: • Social reform to remove mentally ill from prisons to their own hospitals. • Pushed for government funding of treatment facilities.

  6. Using Psychology/Science for Social Control and Discrimination • Francis Galton: • Eugenics: selective breeding for improving the human gene pool • Mental traits are inherited (Galton was focused on IQ) • James Cattell: • Coined “mental test”, supported Galton’s idea of eugenics, promoted sterilization • Alfred Binet: • Intelligence test (original French version) • Robert Yerkes: • Army Alpha and Army Beta • Lewis Terman: • Translation of Binet’s Intelligence Test  Standford-Binet

  7. Using Psychology/Science for Social Control and Discrimination • IQ became the predominate means of “sorting” people in the early 1900’s • Goddard promoted screening immigrants at Ellis Island to prevent individuals with low IQ’s from entering U.S. • Interpretations of WWI recruit testing suggested racial differences in IQ • Placing students in schools

  8. Mental Illness in 1930’s Germany • Action (Aktion) T4: • German physicians were instructed to euthanize mentally ill, mentally disabled, and physically handicapped individuals. • Applied to both children and adults • Parental consent at first for children; later without parental consent

  9. Research in the Camps • Military Related Research: • Freezing/Hypothermia • High Altitude • Tuberculosis (TB) • Malaria • Sulfanilamide • Wounds • Sea Water • Poison • Limb Transplant • Various Infectious Diseases

  10. Research in the Camps • Genetic Research: • Artificial Insemination • Sterilization Techniques • Physiology/Dissections • Mengele’s Twin Studies

  11. Tuskegee Syphilis Experiment • The progression of syphilis (STD): • Primary Stage (up to 90 after infection) • Lesion and skin ulceration, usually at the point of contact • Secondary Stage (1-6 months after infection) • Skin rash, cold/flu-like symptoms (headache, soar throat, fever), weight loss • Latent Syphilis • Lack of signs and symptoms for extensive time, after the second stage symptoms have cleared • Tertiary Stage (a.k.a Late) • Tumor like growths, neurological issues, cardiovascular issues, affect internal organs • Neurosyphilis (affects CNS)

  12. Tuskegee Syphilis Experiment • Background: • Syphilis was becoming an issue • No real understanding of the progression of the disease • A study was proposed to examine the effects of untreated syphilis • Major Orgs Involved: • U.S. Public Health Service (U.S. Gov’t) • Tuskegee Institute

  13. Tuskegee Syphilis Experiment • Location: Tuskegee, Alabama • Participants: • N = 600 African American Males • 399 w/syphilis, 201 without • Low SES, low levels of education, rural area • Participants were enticed with Free medical examinations, meals, and burial insurance • No Informed Consent • Used an African American nurse to gain participant trust

  14. Tuskegee Syphilis Experiment • 1930’s to 1970’s • Participants were told they’d be treated for “Bad Blood”. • Local doctors were told not to treat men in the study. • Participants given placebo pills • Penicillin withheld (most effective treatment) • Draft Board agreed not to treat men in the study

  15. Tuskegee Syphilis Experiment • Results: • Many infected participants died from the disease and its complications (during the study) • Several wives and children infected • $10 million class-action law suit • Created a general distrust of health care officials

  16. Milgram Experiment • The use of deception in research • Milgram wanted to know how powerful authority was to the individual. • Set up a “Learning” experiment, in which electric shocks would be give by the teacher (participant) upon the learner’s (an actor) incorrect responses. • The voltage meter marked with several levels of shock intensity (mild to lethal) • Most people will conform and follow orders to the extreme • http://www.youtube.com/watch?v=y6GxIuljT3w (not the original study)

  17. Stanford Prison Experiment (1971) • Zimbardo set up a Prison simulation with guards and prisoners. • How do people identify with roles? • Students in the roles (allowed to take their own actions): • Guards became abusive to prisoners • Prisoners acted out, planned escapes, rebelled • Zimbardo was the Prison Superintendent • A conflict of interest for objective research

  18. Psychology and the Law • Competency and Insanity • Dusky v. US (1960) • Dusky Standard • Pate v. Robinson (1966) • Due process includes right to competency hearing • Drope v. Missouri (1975) • Cannot deny treatment/leave of absence • Fredak v. US (1979) • Cannot force defendant to plea insanity • Ford v. Wainwright (1986) • The mentally insane cannot be executed • Godinez v. Moran (1993) • Competency must be evaluated before council can be waived and a plea is entered

  19. Psychology and the Law • Involuntary Confinement: • Jackson v. Indiana (1972) • Cannot hold people indefinitely • O’Connor v. Donaldson (1973) • Cannot confine individuals who are non-dangerous or capable of living on their own

  20. Psychology and the Law • Medication and Forced Treatment: • Skinner v. Oaklahoma (1942) • Cannot force inmates to be sterilized before re-entry to the community • Rennie v. Klein (1978) • Patients have the right to refuse medication • Washington v. Harper (1990) • Can force medication if patient is dangerous to self or others • Perry v. Louisiana (1990) • Cannot force medication to carry out an execution

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